AMA backs comprehensive approach targeting sugary drinks

Obesity remains a growing epidemic that needs to be addressed. With increased evidence of a connection with added sugar consumption, delegates joined forces in agreement to find solutions for improved health outcomes across the spectrum.

At the 2017 AMA Annual Meeting, the House of Delegates (HOD) took action on sugar-sweetened beverages (SSBs), and availability of healthful foods in hospitals, food banks and food-assistance programs.

Some hospitals and other medical facilities currently ban the sale of SSBs to help limit access to patients, visitors and employees. With the mounting evidence of a connection between added sugar consumption and obesity, these programs strive to improve health outcomes.

In hopes of limiting the consumption of beverages with added sugars, the AMA adopted policy encouraging “hospitals and medical facilities to offer healthier beverages, such as water, unflavored milk, coffee and unsweetened tea, for purchase in place of SSBs.” Delegates also will ask such outlets to display “calorie counts for beverages in vending machines to be visible next to the price.”

Sugar consumption exceeds recommended limits, according to data cited in a Council on Science and Public Health report. New AMA policy encourages physicians to suggest their patients “replace SSBs with healthier beverage choices, as recommended by professional society clinical guidelines.” Physicians should also work with “local school districts to promote healthy beverage choices for students.”

Delegates also adopted policy favoring evidenced-based strategies to reduce consumption of SSBs including: imposing excise taxes, restricting access to SSBs in schools and other settings, using warning labels to educate consumers on the health harms of SSBs and using plain packaging. The council’s report cited a projection that cutting sugar consumption could save nearly $1 billion in health care costs, primarily due to diabetes prevention.

“Excessive sugar consumption has been linked to some of the nation’s most debilitating diseases, and limiting the consumption of sugar-sweetened beverages will go a long way toward helping people prevent the onset of these diseases, improve health outcomes, and rein in health costs associated with chronic diseases,” said AMA Board Member William E. Kobler, MD.

In addition, the HOD adopted policy encouraging “state and local medical societies to support the adoption of state and local excise taxes on sugar-sweetened beverages, with the investment of the resulting revenue in public health programs to combat obesity.”

The AMA will also “assist state and local medical societies in advocating for excise taxes on SSBs as requested.”

Along with moving to cut down on sugary drinks served in hospital, the AMA will “call on United States hospitals to improve the health of patients, staff and visitors by providing a variety of healthful food, including plant-based meals, and meals that are low in fat, sodium and added sugars.” Delegates also want hospitals to “eliminate processed meats from menus.”

Healthier options for poor families

Compared with others, Supplemental Nutrition Assistance Program (SNAP) participants have been shown to have less healthful diets. This is because SNAP—formerly known as the Food Stamp Program—pays retailers for unhealthy foods, according to the authors of an HOD resolution.

In response to SNAP’s potential impact on the health of Americans and their need for medical care, delegates directed the AMA to “request the federal government support SNAP initiatives to incentivize healthful foods” while discouraging or eliminating unhealthful foods. This new policy also asks the federal government to “harmonize SNAP food offerings with those of Special Supplemental Nutrition Program for Women, Infants, and Children.”

Food banks remain in a model position to positively impact the health of local community members through various initiatives. However, they are pressed economically to stock food items that last longer and provide more meals. These foods tend to be calorically rich and nutritionally poor.

In response, the HOD amended current policy to:

Support the use of existing national nutritional guidelines for food banks and food pantries.

Promote sustainable sourcing of healthier food options and the dissemination of user-friendly resources and education on healthier eating for food banks and food pantries.

“We know that food-insecure individuals often face great difficulty meeting the recommended daily amount of certain vital nutrients, putting them at significantly higher risk for nutritional deficits and associated negative health consequences,” said AMA Board of Trustees member Willarda V. Edwards, MD, MBA. “We must do everything we can to make sure that all Americans have access to nutritious foods and resources to help them make healthy food choices.”

Obesity stigma prompts new language

Patients affected by obesity are often victims of bias and stigma in not only their lives, but in our health care systems as well, according to data cited by the authors of a resolution considered at the HOD. To form a therapeutic alliance with patients, the AMA adopted policy encouraging “the use of person-first language in all discussions, resolutions and reports regarding obesity.” New policy adopted by the HOD also includes:

Educating health care providers on the importance of person-first language for treating patients with obesity.

The HOD adopted policy encouraging “the use of preferred terms regarding patients affected by obesity including weight and unhealthy weight, and discouraging the use of stigmatizing terms, such as obese, morbidly obese and fat.”